Hospitals look to avoid Medicare penalties for 'boomerang' patients

Fines are being levied against hospitals with high rates of patient readmission under a provision of the Affordable Care Act targeting $8 billion in Medicare cost savings within six years, Bloomberg reports. That has hospitals nationwide, including the Cleveland Clinic, “going the extra mile to prevent the return of these boomerang patients.”

Under the health care reform law, Bloomberg notes, “hospitals with a high number of readmissions within 30 days can lose as much as 1 percent of their Medicare payout for fiscal 2013 and 3 percent in 2015.” The program, which started with discharges beginning Oct. 1, focuses on Medicare patients suffering from heart failure, heart attack and pneumonia.

The penalties may cost the industry $280 million this year, according to an August report by Medicare. Bloomberg says average fines for a hospital with a penalty is about $125,000, according to the September report from the Medicare Payment Advisory Commission, which advises Congress on Medicare issues.

Among steps most hospitals take: getting in touch with former patients after they've been released, urging them to keep doctor appointments; and providing free medicine to some patients who can't afford prescriptions and contact pharmacies to make sure pills are ready for pick-up.

But there's only so much a hospital can do for someone who's no longer a patient. Teaching hospitals that handle especially challenging cases may get hit hard under the law's readmission provision, says Catherine Keating, chief of regional hospitals medical affairs at the Cleveland Clinic.

“We don't want to penalize hospitals for taking the riskiest or sickest patients. And we don't want hospitals to feel they have to shuttle patients off to another center,” Ms. Keating tells Bloomberg.

In a research letter last month in the Journal of the American Medical Association, Karen Joynt, a cardiologist at Brigham and Women's Hospital in Boston, “wrote that 7 in 10 hospitals face Medicare payment cuts under the law, with 'safety-net' and teaching facilities hardest hit,” according to Bloomberg. (The study reviewed records for 3,282 U.S. hospitals and medical centers.)

The fines would be imposed even though readmissions often occur for reasons beyond a hospital's control, Dr. Joynt says.

“If I have a pneumonia patient and they break their hip, I'm sorry, but should the hospital be penalized?” she asks.

An HR buff

KeyCorp has hired a Bank of America veteran as its chief human resources officer.

American Banker reports that Craig Buffie will be responsible for implementing the human resources strategy for KeyCorp's 15,500 employees in the United States and abroad. He also has joined the $89 billion-asset KeyCorp's executive management team and executive council, and reports to CEO Beth Mooney.

Mr. Buffie held several jobs during a 27-year career at Bank of America, the newspaper reports. Most recently, he served as its head of home loan sales and fulfillment. He's a Penn State alum and also has an MBA in finance and marketing from Kelley School of Business at Indiana University.

Mr. Buffie “possesses deep business and human resources leadership skills with a proven ability to help drive business improvement,” Ms. Mooney says. He brings “a unique perspective that will enable him to lead our efforts to attract, retain and engage a diverse and talented work force."

Progress, but ....

The number of women taking the role of chief financial officer increased 35% at big U.S. companies in the past year, “putting more female executives in the top ranks of management after decades of slow gains,” Businessweek.com reports.

There were 54 women serving as CFO among Standard & Poor 500 Index companies as of last month, up from 40 a year earlier, according to data compiled by Bloomberg Rankings. While men still account for almost 90% of CFOs in the index, “the growth marks progress for female managers at a time when there's been little change at the chief executive officer level,” according to the story.

Indeed, women now oversee the finances at such high-profile companies as JPMorgan Chase & Co., the newspaper chain Gannett Co. and Time Warner Cable Inc., the second-biggest U.S. cable company. The trend “comes at a time when the CFO job itself is becoming more critical,” the story notes, as the Sarbanes-Oxley Act of 2002, which required companies to be more transparent about their finances, “thrust CFOs into the limelight and forced them to work more closely with chief executives.”

Still, Businessweek.com reports that making the jump to CEO remains elusive for women.

“Just 21 of the CEOs at S&P 500 companies are women, or 4 percent — a figure that's barely budged in the past five years,” according to the story. “Taking the top job usually requires experience running a previous business or at least a large division. That's a hurdle for some women, though CFOs are increasingly arriving at the position with more operational experience.”

In all, women held 14% of all senior-executive jobs last year. But 28% of Fortune 500 companies in 2012 didn't have any women in C-suite positions at all — a list that includes Apple Inc., Exxon Mobil Corp. and Berkshire Hathaway Inc.